AccountId: 011433970860
ContactId: 3bb3baa2-6f04-44a5-bc12-44d8b1796636
Channel: VOICE
LanguageCode: en-US
Total Conversation Duration: 473399 ms
Total Talk Time (AGENT): 144484 ms
Total Talk Time (CUSTOMER): 167254 ms
Interruptions: 0
Overall Sentiment: AGENT=0.3, CUSTOMER=0.1
Redaction Types: PII
Input Audio S3: s3://apl-connect-contactcenter-data-prod/connect/apl-prod/CallRecordings/2025/02/11/3bb3baa2-6f04-44a5-bc12-44d8b1796636_20250211T20:54_UTC.wav
--------------------------------------------
[AGENT][NEUTRAL] Good afternoon. Thank you for calling ATL. This is speaking. May I help you?
[CUSTOMER][NEUTRAL] Hey, I was needing help with um some claims for one of our patients.
[AGENT][NEUTRAL] OK, I can verify claim status for you and your name is?
[CUSTOMER][NEUTRAL] [PII].
[CUSTOMER][NEUTRAL] And how do you spell your name?
[AGENT][POSITIVE] [PII], and that's such a pretty name.
[CUSTOMER][POSITIVE] Oh, thank you. I like [PII] too.
[AGENT][NEUTRAL] I always think of the, think of the soap opera lady on God and Light, I think her name was [PII] and they call her [PII].
[CUSTOMER][NEUTRAL] Oh, really? OK, OK.
[AGENT][NEUTRAL] Yeah, she's a longtime character on there, but anyway.
[AGENT][NEUTRAL] Um, and what's that policy number, please?
[CUSTOMER][NEUTRAL] Yeah.
[CUSTOMER][NEUTRAL] Sure, um, I have 0227.
[CUSTOMER][NEUTRAL] 2731 ML 8.
[AGENT][NEUTRAL] OK, and do you have a callback number in case the call drops?
[CUSTOMER][NEUTRAL] Yeah, I'm at [PII] and that's the direct number.
[AGENT][NEUTRAL] OK, and verify the patient's name, date of birth.
[CUSTOMER][NEUTRAL] Uh, it's for [PII]. Oh my gosh, I don't not know how to send this. I'm not sure. [PII]. I'm not sure how to pronounce.
[AGENT][NEUTRAL] You're fine.
[CUSTOMER][NEUTRAL] [PII] and her date of birth is [PII].
[AGENT][NEUTRAL] We can just say Ms. [PII] is fine.
[CUSTOMER][NEUTRAL] Yeah, exactly, it's [PII], that's who she is.
[AGENT][NEUTRAL] And you say you're wanting to check claim status?
[CUSTOMER][NEUTRAL] Yes, ma'am, yeah.
[AGENT][NEUTRAL] Uh, what was the date of service and the amount of the charge?
[CUSTOMER][NEUTRAL] Um, the first one, jeez, because there's a few, I don't, let me see, the first one was for, um, [PII] excuse me, [PII] for $277.
[AGENT][NEUTRAL] OK, see.
[AGENT][NEUTRAL] Uh, do you have the balance after primary?
[CUSTOMER][NEUTRAL] After their primary, yeah, let me see what there as well. Hold on, I apologize.
[AGENT][NEUTRAL] Uh-huh.
[CUSTOMER][NEUTRAL] Uh
[CUSTOMER][NEUTRAL] OK
[CUSTOMER][NEUTRAL] Bye
[CUSTOMER][NEUTRAL] And I gave you the 5th, right?
[AGENT][NEUTRAL] Yes, ma'am.
[CUSTOMER][NEUTRAL] OK
[CUSTOMER][NEUTRAL] They came back and.
[CUSTOMER][NEUTRAL] It's all kind of
[CUSTOMER][NEUTRAL] Coinsurance was 5583.
[CUSTOMER][NEUTRAL] Wait a minute here, how are they doing this?
[CUSTOMER][NEUTRAL] This is 545,450.
[AGENT][NEUTRAL] And you're calling from?
[CUSTOMER][NEUTRAL] It's weird.
[CUSTOMER][NEUTRAL] Apex physical therapy.
[AGENT][NEUTRAL] OK.
[CUSTOMER][NEUTRAL] Yeah.
[CUSTOMER][NEUTRAL] Yeah
[CUSTOMER][NEGATIVE] OK, do you see one for 454, and then they pay, uh, did they pay anything? I don't think they pay. They didn't pay anything. They pushed um $55.83 to uh co-insurance.
[AGENT][NEUTRAL] OK.
[AGENT][NEUTRAL] Uh, shall we process that claim and pay, but I think we're off by 3 cents.
[CUSTOMER][NEUTRAL] OK.
[AGENT][NEUTRAL] Uh, we paid 55. 76.
[AGENT][NEUTRAL] I think we're off by 3 cents. Let's see.
[AGENT][NEUTRAL] OK.
[AGENT][NEUTRAL] Uh, more, probably more than.
[AGENT][NEUTRAL] 7 cents. We're off by 7 cents.
[CUSTOMER][NEUTRAL] That
[CUSTOMER][NEUTRAL] OK
[CUSTOMER][NEUTRAL] Well, when was it um paid do you know?
[AGENT][NEUTRAL] I see.
[AGENT][NEUTRAL] 20334.
[AGENT][NEUTRAL] It cleared [PII], um, this year, issued [PII].
[CUSTOMER][NEUTRAL] OK.
[CUSTOMER][NEUTRAL] Oh, that's where 7.
[CUSTOMER][NEUTRAL] OK, so what should we do about that service then?
[AGENT][NEUTRAL] Uh, I can send it back, uh, for reprocessing, just let them know it's off by 7 so they can mail out for 7 cents.
[CUSTOMER][NEUTRAL] Uh-huh.
[CUSTOMER][NEUTRAL] OK, can, can we get that um.
[AGENT][NEUTRAL] Uh.
[CUSTOMER][NEUTRAL] Yeah
[AGENT][NEUTRAL] Yeah, I'll send it back for reprocessing or ask them to review because uh just inform him off by 7 cents.
[CUSTOMER][NEUTRAL] OK, OK, do you, you don't happen to have um.
[CUSTOMER][NEUTRAL] The [PII].
[CUSTOMER][NEUTRAL] Of October by any chance.
[AGENT][NEUTRAL] See, and what was the amount of that one? October.
[CUSTOMER][NEUTRAL] Uh, 45,450, yeah.
[AGENT][NEUTRAL] OK, let me look at. Oh, and how much was it after primary?
[CUSTOMER][NEUTRAL] Yeah.
[CUSTOMER][NEUTRAL] Um, sorry, go back.
[CUSTOMER][NEUTRAL] Yeah
[AGENT][NEUTRAL] Was this for diagnostic services for this one?
[CUSTOMER][NEUTRAL] No, this is, uh, she's just physical therapy.
[CUSTOMER][NEUTRAL] Um, it was still 5583 for that one.
[AGENT][NEUTRAL] Oh,
[AGENT][NEUTRAL] OK, I don't show. Give me one moment.
[CUSTOMER][NEUTRAL] OK.
[CUSTOMER][NEUTRAL] You might not have it yet. It doesn't, you probably don't have it.
[AGENT][NEUTRAL] Hm.
[AGENT][NEUTRAL] One
[AGENT][POSITIVE] That's where kids are funny.
[CUSTOMER][NEUTRAL] Yeah.
[AGENT][NEUTRAL] Sorry about, uh, it's OK. It's like, can I have 2 cookies? No, 1.
[CUSTOMER][NEUTRAL] Mhm
[AGENT][NEUTRAL] OK, I don't show we received that claim for [PII].
[CUSTOMER][NEUTRAL] OK, yeah, I'm gonna get that one over. OK, um, do we have, what's the time is that, are we still within time?
[AGENT][NEUTRAL] Uh, there's no time limit.
[CUSTOMER][NEUTRAL] Oh, OK, OK, perfect. Do you offer a call reference number for me?
[AGENT][NEUTRAL] Yes, ma'am.
[AGENT][NEUTRAL] Uh, no, but if you like, you may use my name at today's date.
[CUSTOMER][POSITIVE] Sure, perfect. That works for me. All right, thank you so much for all your help. You have a good rest of your day.
[AGENT][POSITIVE] Alright, you too, Ms. [PII], and thanks for calling APL.
[CUSTOMER][NEUTRAL] OK.
[CUSTOMER][NEUTRAL] OK, bye bye now.
[AGENT][NEUTRAL] Bye.